Provider Demographics
NPI:1891525879
Name:EWING, SHAWNA ANNE (LPC CANDIDATE)
Entity type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:ANNE
Last Name:EWING
Suffix:
Gender:F
Credentials:LPC CANDIDATE
Other - Prefix:
Other - First Name:SHAWNA
Other - Middle Name:ANNE
Other - Last Name:GREEN/SPOHN/SPONSEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2500 S BROADWAY STE 250
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-4045
Mailing Address - Country:US
Mailing Address - Phone:405-395-7502
Mailing Address - Fax:
Practice Address - Street 1:2500 S BROADWAY STE 250
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-4045
Practice Address - Country:US
Practice Address - Phone:405-395-7502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health